Provider Demographics
NPI:1386791051
Name:HIGHSMITH, WYKEISHA LATRICE COOPER (APRN)
Entity type:Individual
Prefix:
First Name:WYKEISHA
Middle Name:LATRICE COOPER
Last Name:HIGHSMITH
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:WYKEISHA
Other - Middle Name:LATRICE
Other - Last Name:COOPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:312 CROSSTOWN DR UNIT 297
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-2948
Mailing Address - Country:US
Mailing Address - Phone:678-271-0190
Mailing Address - Fax:678-271-0072
Practice Address - Street 1:7750 E BROADWAY BLVD STE A-100
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-3901
Practice Address - Country:US
Practice Address - Phone:520-449-8555
Practice Address - Fax:520-207-6808
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP3635363LP0808X
NVAPN000927363LP0808X
WAAP61419176363LP0808X
GARN196899363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health